Technological Breakthroughs in POP Surgery

Abstract

The pelvic floor in women is a complex and highly vulnerable structure. Injuries and functional modifications of this complex due to pregnancy, life events, and aging often lead to pelvic organ prolapse (POP). Following the definition of a joint report by the two leading urogynecological societies [1], POP is defined as “any descent of one or more of the anterior vaginal wall, posterior vaginal wall, the uterus (cervix) or the apex of the vagina (vaginal vault or cuff scar after hysterectomy).” The different types of prolapse include apical vaginal prolapse, i.e., uterus and vaginal vault (after hysterectomy when the vaginal vault prolapses); anterior vaginal wall prolapse, i.e., cystocele (bladder prolapse), urethrocele (urethra prolapse), and paravaginal defect (pelvic fascia defect); and posterior vaginal wall prolapse, i.e., enterocele (small bowel prolapse), rectocele (rectum prolapse), and perineal deficiency. Women may present prolapse of one or more of these anatomical structures. POP may be associated with other pelvic floor dysfunctions such as sexual dysfunction, urinary incontinence (UI), chronic obstructive defecation syndrome (ODS), and constipation. Typical symptoms of POP are vaginal bulging, pelvic pressure, vaginal bleeding, discharge and infection, and low backache. All these symptoms have a profound social, psychological, and sexual impact, and they severely affect quality of life [2].